Unwelcome Visitors: Is EMS Ready for Fire Ants and Killer Bees?

     In January a 47-year-old man was viciously attacked by bees while working in the backyard of his home in Cape Coral, FL. His daughter, responding to his screams, came running and found him covered by a swarm. Her father is allergic to bee stings. She went back into the house to call 9-1-1. Firefighters arrived and sprayed water on the man in an attempt to remove the bees. It didn't work. Instead, they had to strip off the man's clothes and, with gloved hands, get the bees off him. "I've never seen bees so aggressive in my life," the daughter said. Firefighters estimated there were 40,000-50,000 bees in the 2' x 3' hive that had been disturbed. The man was emergently transported to a local hospital and placed on a mechanical ventilator. He spent 48 hours in the ICU and ultimately did well.

     International travel and global exploration have effectively made the world much smaller. With these travels, animal and plant species are sometimes introduced, either intentionally or accidentally, to new geographic areas. Sometimes this is beneficial. More often, it is harmful.

     The United States has had several unwanted species introduced. Of these, fire ants and Africanized honeybees (AHBs), also known as killer bees, have become a particular problem. Both have progressively spread across the United States and, especially in the case of AHBs, pose significant health risks.

Fire Ants
     Fire ants (Solenopsis invicta), also referred to as red imported fire ants, originated in South America and came to the United States through the port of Mobile, AL, in the 1930s. Fire ants are medium-sized ants that build mounds of soft soil. The mounds are relatively small compared to those of other ant species. Fire ants are attracted to electrical currents and commonly build their mounds near electrical lines and equipment. When disturbed, they emerge aggressively from their mound and sting repeatedly. Their sting causes immediate pain and usually leaves a white pustule on the skin.

     Fire ants have slowly spread from Alabama throughout the southeastern United States, and are now spreading westward through the desert southwest into California. Attempts to control them have been largely unsuccessful.

EMS Considerations
     Fire ants are extremely aggressive and inflict numerous stings. Children and babies are most susceptible to fire ants. For adults, the stings can be painful. However, for those allergic to ant venom, the stings can induce an allergic reaction or even anaphylaxis.

     Their venom is only lethal in large quantities. It is an alkaloid and causes pain. It is also a hemolytic, causing swelling. Fire ants can sting repeatedly, administering large quantities (relatively speaking) of venom.

     If you are called to treat a person attacked by fire ants, ensure you are wearing gloves and other personal protective equipment. If the victim has not been removed from the fire ant mound, do so as soon as possible. With a gloved hand, knock off any remaining ants, as they will continue to sting. Be aware that some ants will get into body crevices. Once the ants are removed, assess the patient. If there are problems breathing or other signs of an allergic reaction, begin treatment. Treatment should include the administration of supplemental oxygen. If allergic symptoms are present (e.g., hives, wheezing, rash, stridor), consider the administration of epinephrine 1:1,000 subcutaneously or intramuscularly. Also, consider administering an antihistamine such as diphenhydramine (Benadryl). If the patient develops anaphylactic shock, consider intravenous epinephrine, inhaled beta agonists and possible corticosteroids. For patients without allergic symptoms, instruct them to clean the ant stings with soap and water and apply a drying solution such as calamine lotion. The lesions will usually clear in 48 hours.